In people who have cirrhosis, high blood pressure in the veins that carry blood fro the intestines to the liver (portal hypertension) causes many problems. One serious complication of portal hypertension is variceal bleeding.
When blood pressure increases in the portal vein system, veins in the esophagus, stomach, and rectum enlarge to accommodate blocked blood flow through the liver. The presence of enlarged veins (varices) usually cases no symptoms. About 50 – 60% of people who have cirrhosis develop varices in the esophagus.
As the blood pressure in the portal vein system continues to increase, the walls of the expanded veins become thinner and eventually rupture and bleed. This is called variceal bleeding.
Typically nonbleeding varices are asymptomatic. Once varices are bleeding, patients present with symptoms of an upper gastrointestinal hemorrhage such as hematemesis, passage of black or bloody stools, lightheadedness, or decreased urination.
Esophageal and gastric varices are best diagnosed by endoscopy, which may also identify varices at high risk of bleeding. Endoscopy is also used to exclude other causes of acute bleeding, such as a peptic ulcer.
The American College of Gastroenterology recommends endoscopic screening for varices for anyone who has been diagnosed with cirrhosis. If your first test does not identify any varices, you can be tested again in 2 to 3 years. You may require more frequent testing if you have large varices or have already had an episode of variceal bleeding, recurrent bleeding is common.
Laboratory tests such as CBC with platelets, PT, PTT and liver function can also be used to evaluate patients for a bleeding disorder (coagulopathy).
In about 40% of cases, variceal bleeding stops spontaneously. If bleeding continues, emergency techniques to shunt blood from the portal system to the vena cava can lower portal pressure and diminish bleeding. A transjugular intrahepatic portosystemic shunt (TIPS) procedure is the emergency intervention of choice. TIPS is the percutaneous formation of a tract between the hepatic vein and the intrahepatic segment of the portal vein in order to reduce the portal venous pressure.
Dr Jason Bauer performed our 20 year old son’s kidney biopsy last week. I have had a lot of experience with medical care. Dr Bauer has moved to the top five of all doctors we have encountered. He has taught us more about our son’s medical condition than any other doctor has since March 2019! I just kept wanting to ask him more questions 😄. I felt super confident that our son was getting the best care he could when I let him go into the procedure. Dr Bauer’s skill, knowledge and ability to translate it into lay peoples terms far exceeded FIVE STARS and our expectations. He also related to our young adult son well which put him at ease.
A.R.Wonderful nurse, did a good job. I am thrilled and excited. (EVLT Patient)
C.W.If I have to have another drain ever I will come to IVC. Everyone is so great there.
P.P.Your office has done a great job at follow up.
E.M.You all are so nice. Thank you for being there. Your facility is so great. So happy not to have to go to the hospital for this.
P.A.You all were wonderful. My experience started with the pre-procedure call – where comfort, trust and confidence was gained. Mary Anne is an asset. Thanks to Vicky, Paul and Dr. Pfister for their true care & concern.
M.I.Thank you all, the team was great to work with. I appreciate your care.
C.D.Your team is exemplary. This leads to outstanding results. Thank you for being great!
I.S.Everyone at the oncology clinic said how great the port looked today!
S.V.M.Thank you for the time you spent with me today on the phone. You made a big difference. More than I can express. You have given me hope, calmed my anxiety and informed me. I was getting confused by all of the different instructions and restrictions by others.
R.M.You made this painless. Your team works together well. Thank you. I feel better already!
M.R.Best doctors in town! Dr. Zhang speaks fluent Mandarin which was very helpful to my uncle!
A.C.You guys were so AWESOME! Thank you for making this scary procedure go smooth and making me comfortable. You all are great.
C.P.I am a medical oncologist who has been referring my patients to the physicians at IVC for 8 years now. In my career, I have never worked with a more dedicated, thorough, humane, and technically superb group of physicians. I have received countless words of positive feedback from my patients echoing the above sentiments.
More recently, I have been a patient with Dr. Michael Pfister. Dr. Pfister is an outstanding interventionalist, who brings a warm bedside manner to his interactions. He is the “whole package,” providing both technical savvy as well as kindness. As a patient, I could not ask for more.
I.S.I’ve been a pt of Dr. Pfisters for over 10yrs, during which time he has performed 5+ procedures. As a medical professional myself, I have an exceptionally high expectation of the quality of care I receive, as well…and JUST AS IMPORTANT…the attitude and respect my Dr’s and healthcare team provide! Dr. Pfister and the staff on his team get AA+++ from me!!!!! He is kind, respectful, informative AND an EXCEPTIONALLY skilled interventional radiologist!!! I won’t EVER trust anyone else!!!
P.R.From the time I first spoke to Maryanne who was so kind, and walked thru your doors with friendly smiles to greet me – meeting Patty who was so kind and caring and meeting Dr. Love – great bedside manner and smile and made sure all my questions were answered – and having the port placed with an excellent team – Paul asking me what my hobbies were first thing – I knew I was in the right place! Thank you all, you all are amazing!
AnonymousOne of our best medical experiences during our entire cancer treatment. Thanks so much for everything!
AnonymousThis is for Dr. Pfister. I just wanted to thank him for all the time he spent with us the other week. In all the years I’ve had my vascular problems I’ve never had a doctor really sit down and explain to me the intricacies of what might be going on. I have a lot to think about…but just wanted to say thanks for being so nice and answering our many questions!
L.H.A fantastic group of wonderful people. The procedure was very smooth. When they were putting the port in I felt like I was getting a great massage!! Thank you all!
S.C.Charley was instrumental in getting me scheduled in quickly to get my PICC line removed. She actually worked until late in the day to get the information from my referring doctor’s office. It is nice to know great people like Charley still exist in this world!
K.S.I had my blood clot filter removed on 2/21/18. I was very apprehensive, yet EVERYONE in Dr. Pfister’s office and surgical team helped to make me comfortable. I am extremely claustrophobic so laying down or having something covering my face creates anxiety. Mary Anne listened to my concerns and made sure I was made comfortable and did not feel anxious. The surgical team was amazing, they explained everything thoroughly. Dr. Pfister came in after the procedure to review what he did and discuss any follow up that might be required. I so appreciate the time and attention he gives me as his patient. This was a positive experience.
G.H.110% Thank You! Best unit so far in my cancer treatment. Thanks Dr. Love
AnonymousIf you ever need an Interventional Radiologist for a child I realize it is serious business. I’ve seen Dr. Love go and save a child’s kidney without missing a beat. I could recommend no one better for myself, or for people I love. I think he is a little cool at the bedside, but that’s OK Dr. Love, stay frosty! If you can’t see Dr. Love, one of the other professionals at IVC will be able to help you. Ashley, the dynamite scheduler and one of the other surgeons at IVC will care for you. I’ve had multiple surgeries with this practice over the past several years. Never a hiccup!
S. R. – Portland, ORGreat experience, doctor was thorough in explaining what was going to happen. The nurses were very attentive and made sure I was comfortable and my needs were met. I would recommend this office for any related procedure.
AnonymousEverything went very smoothly. Joe enjoyed the music. Very friendly staff! Good Experience!
J. & E.All staff was courteous and efficient. Good experience.
J. J.Dr. Pfister, thanks so much for your excellent care, removing my chemo port earlier this week. With all your experience and your fine touch, I’m confident the scar will be nearly invisible. Your team, from beginning to end, did a super job with me. Please extend my gratitude to Jennifer, Mary Anne, Todd and Charley. I’ve got a whole lot of living left to do. I appreciate all of you helping me do it!
M. F.Dr. Pfister, thank you for all of the attention you gave to me. I learned lots from our discussion – hearing you speak of ultimate healing was enough to encourage me to do all I can to strengthen those muscles.
S. O.The entire office is one of the most professional, helpful and informative medical offices I have dealt with (and I have dealt with many). Kudos to Jennifer, Henry, and Charley!
K. C.Great people. Great place. Good surgery.
G. G.Patty, Mary Anne and the whole staff was amazing! Best experience I’ve had since being diagnosed with cancer. From start to finish, was great. Thanks.
MMy brother came into Legacy Meridian Park, had a stroke. Dr. Bauer came in immediately, in his work jeans and shirt. He worked with Neurologist Dr. Burbank, developed a plan and took my brother into a procedure where they removed the clot from his head! Very down to earth doctor, explained procedure to family, worked with sense of urgency.
J. P.I want to comment regarding Dr. Bauer of how he was thorough explaining my CT Biopsy and showing me how on the computer he would get the tissue needed. In all the years of several surgeries I have never felt better going in to have a procedure done. His bedside manner was incredible. I wish all doctors were like Dr. Bauer. Thank you for preparing and relaxing me prior to the biopsy.
R.S. Molalla OREveryone did a superb job taking care of me and doing the procedure. Thank You All
K.S.Dr. Bauer genuinely cares about his patients and strives to make sure they understand every aspect of their treatment.
A.L.Dr. Bauer, our family wants you to know how thankful we are to you for saving G.P.’s life and bringing him back to us in normal health. Thank you over and over you are the best!
Family of G. P.
We are announcing that Interventional and Vascular Consultants will be closing as of March 10, 2023.
We would like to thank you for the trust you have given us over the years, participating in your healthcare needs has been a privilege.
To assist in a smooth transition to a new provider, you may access your records from your MyHealth account or request a copy of medical records by clicking the link below and completing the Release of Information form.
Please know that we have greatly valued our relationship with you and wish you the best.
Sincerely,
Jason Bauer, MD RVT
Michael Pfister, MD RVT
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